Provider Demographics
NPI:1770802035
Name:CURTIS, TARA (MA)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:CURTIS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 REGENT ST STE 302
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53715-2634
Mailing Address - Country:US
Mailing Address - Phone:608-257-9700
Mailing Address - Fax:
Practice Address - Street 1:700 REGENT ST STE 302
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53715-2634
Practice Address - Country:US
Practice Address - Phone:608-257-9700
Practice Address - Fax:319-863-1311
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
WI8021-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional